[1] The pia mater that surrounds the spinal cord, however, projects directly downward, forming a slender filament called the filum terminale, which connects the conus medullaris to the back of the coccyx.

[4] It typically causes back pain and bowel and bladder dysfunction, spastic or flaccid weakness depending on the level of the lesion, and bilateral sensory loss.

Comparatively, cauda equina syndrome may cause radicular pain, bowel/bladder dysfunction, patchy sensory loss or saddle anesthesia and lower extremity weakness at the level of the lumbar and sacral roots.

Pediatric patients may have a syrinx associated with their Chiari malformation and the conus medullaris will be located at or below the L2–L3 lumbar vertebrae disk space.

[5] Isolated infarcts of the conus medullaris are rare, but should be considered in patients with acute cauda equina syndrome, especially in females.